Musculoskeletal disorders and the physical activity of territorial army soldiers during the COVID-19 pandemic

The impact of COVID-19 related lockdown restrictions on musculoskeletal health: a systematic review

There is limited empirical evidence on whether Coronavirus disease 2019 (COVID-19) related lockdown restrictions precipitate or perpetuate musculoskeletal (MSK) disorders. This study was aimed to synthesis literature that assessed the impact of COVID-19 related lockdown restrictions on MSK health. A literature search was conducted using MEDLINE, CINAHL, PsycINFO, Allied and Complementary Medicine Database (AMED), Web of Science, and Scopus databases. Studies meeting the following criteria were included in the review: the condition being considered was MSK health, the intervention was COVID-19 related lockdown restrictions, cross sectional studies, cohort studies, case controlled, prospective studies and retrospective studies. Data were extracted by 2 independent researchers. Risk of bias was assessed by the Newcastle-Ottawa quality assessment scale. Evidence from included studies was summarised using narrative synthesis. Fourteen studies comprising 22,471 participants of the general population from Turkey (n = 5), Italy (n = 1), Poland (n = 1), Australia (n = 2), Jordan (n = 1), Bangladesh (n = 1), Estonia (n = 1), the Netherlands (n = 1) and Saudi Arabia (n = 1) have met the inclusion criteria. The sample size of populations studied ranged from 91 to 1054. The included studies used questionnaire, visual analogic scale, or growth mixture modelling. Except for one study, all the included studies reported increased prevalence and incidence of MSK disorders due to COVID-19 related lockdown restrictions. The findings suggest that COVID-19 related lockdown restriction led to increased MSK disorders. Home-based strategies such as physical activity programmes and ergonomic workspace could potentially guide public health authorities to avoid MSK health problem.

Functional Movement Patterns, Spinal Posture and Prevalence of Musculoskeletal Symptoms among Elite Ice Hockey Players: A Cross Sectional Study

The aim of this study was to evaluate functional movement patterns and spinal posture of elite ice hockey players and to examine the association between spinal posture, prevalence of musculoskeletal symptoms and Functional Movement Screen (FMSTM) scores. The study included 86 elite male ice hockey players aged 18 to 38 years. Sagittal spinal curvatures were measured with a Saunders digital inclinometer, and functional movement patterns were assessed by the FMSTM. Spinal posture of the studied ice hockey players was characterized by normal kyphosis (46%) or hyperkyphosis (41%) and decreased lumbar lordosis (54%). The mean total FMSTM score was 14.8. Most of the hockey players (57%) achieved a total FMSTM score in the range of 14-17 points, whereas 28% had a total FMSTM score of <14. Seventy-two percent of the studied athletes had at least one asymmetry. Significant differences between performing the movements on the right and the left sides of the body were observed in in-line lunges (p = 0.019) and shoulder mobility sub-tests (p < 0.001). The FMSTM sub-tests performed with the lowest success rates were rotatory stability and the hurdle step. A lower score in the rotatory stability test is related to shoulder pain. It is highly important to develop appropriate exercise programs to reduce or prevent muscle imbalances in ice hockey players.

The association between physical activity and musculoskeletal disorders-a cross-sectional study of teachers

Purpose

Combined with insufficient physical activity (PA) prolonged and improperly performed sedentary work can lead to musculoskeletal disorders (MSDs). The aim of this study was (I) to evaluate the self-reported level of PA and the prevalence of MSDs in male and female teachers, and (II) to investigate the association between PA and MSDs in teachers in Polish primary and secondary schools.

Methods

The study included 254 teachers from primary and secondary schools from Upper Silesia, Poland, excluding physical education teachers. The level of PA was assessed using the Seven-Day Physical Activity Recall (SDPAR). A standardized Nordic Musculoskeletal Questionnaire (NMQ) was used to assess the prevalence of MSDs.

Results

A similar percentage of female (80%) and male (90%) teachers met the WHO recommendations on moderate-intensity PA. The recommendations on performing vigorous-intensity PA were met by significantly (p = 0.002) less female than male teachers (50% and 75% respectively). Lower back disorders during the last 12 months and the last 7 days (57% and 45%, respectively) were the most commonly reported MSDs by teachers, followed by neck (53%, 40%), upper back (39%, 28%), and knee disorders (37%, 26%). The highest pain intensity was experienced by the teachers in the lower back and neck. Teachers with a greater number of MSDs were less likely to engage in vigorous-intensity PA and total PA than those with fewer painful areas of the body. Pain intensity in the neck, knees, upper- and lower back, and wrists/hands was negatively related to moderate and total PA. BMI negatively correlated with total PA, moderate-intensity PA vigorous-intensity PA, and high vigorous-intensity PA.

Conclusions

The study revealed the association between PA and MSDs in studied teachers. The most of the studied teachers met the WHO recommendation, and women were less likely to perform vigorous and high-vigorous PA than men. The lower back and neck disorders were the most common among the teachers.

Increased incidence of acute achilles tendon ruptures in the peri-pandemic COVID era with parallels to the 2021-22 NFL season

PURPOSE

Acute Achilles tendon ruptures (AATRs) are a common sporting injury, whether for recreational athletes or elite athletes. Prior research has shown returning to physical activity after extended periods of inactivity leads to increased rates of musculoskeletal injuries. The purpose of this study was to investigate rates of acute Achilles' tendon ruptures at a single academic institute in the peri-COVID era, with corollary to the recent NFL season.

METHODS

A retrospective search was conducted using current procedural terminology to identify the total number of Achilles acute primary repair surgeries performed from years 2017 to 2021. Non-operatively managed AATRs were identified from the same electronic medical record using ICD-10 codes. NFL data were obtained from publicly available sites according to previously validated studies.

RESULTS

A total of 588 patients who sustained AATRs and underwent primary surgical repair were identified, primarily men (75.7%, n = 445), with an average age of 43.22 ± 14.4 years. The number and corresponding incidence of AATR repairs per year was: 2017: n = 124 (21.1%), 2018: n = 110 (18.7%), 2019: n = 130 (22.1%), 2020: n = 86 (14.6%), 2021: n = 138 (23.5%), indicating a 7.5% decrease in rate of AATRs from 2019 to 2020, followed by an 8.9% increase in incidence from 2020 to 2021. Within the NFL, the number of AATRs resulting in an injured reserve stint increased every regular season from 2019 to 2020: n = 11 (21.2%), to 2020-2021: n = 17 (32.7%), to this past 2021-2022 season: n = 24 (46.2%).

CONCLUSION

AATR surgeries seem to have increased in 2021 following a 2020 COVID pandemic-induced quarantine for recreational athletes at a single academic institution and for professional athletes in the NFL, although these results are of questionable clinical significance. This provides prognostic information when counseling patients and athletes on return to activity or sport.

LEVEL OF EVIDENCE

Level IV.

Musculoskeletal system injuries in the Polish Territorial Defence Forces

BACKGROUND

Musculoskeletal system injuries (MSIs) are the major health problem of soldiers. The aim of this study was to assess the types of MSIs that occurred most frequently among soldiers and which parts of the body they generally affected.

METHODS

The study included 140 Territorial Army soldiers, both men and women, serving in the Polish Territorial Defence Forces (TDF). Times and frequency of MSIs were assessed using an original questionnaire available via a web-based platform, the TDF Information Portal and the Yammer network.

RESULTS

Among the participants, 42% reported MSIs, most often a single one (19%), incurred while doing military service. Damaged muscles and ligaments were the most common injuries in both groups (p>0.05). The knee joint was the main location of injuries for both sexes (24% in men vs 50% in women, p>0.05). Other parts of the body often affected by injuries were the shoulder joint (24%, p>0.05), head, spine, wrist, fingers, ankle and feet (19% each) in the male soldiers and the ankle (24%), spine (14%), head, chest, shoulder joint and foot (10% each) in the female soldiers. Injuries reoccurred with similar frequency in the female and male soldiers (43% vs 40%, p>0.05) and had the same location in both groups (43% vs 40%, respectively, p>0.05). Difficult terrain, too intensive military training and heavy loads were the main risk factors for MSIs in both groups (p>0.05).

CONCLUSIONS

More than half of all the participants (19% of the men and 33% of the women) reported at least one injury incurred during military service. Over 40% of all the study subjects had reinjuries. The males and females were similar in terms of the most common type and location of MSI. Occurrence of MSIs rarely required interruption in the military training/service.

Occupational and leisure time physical activity of territorial army soldiers during the COVID-19 pandemic in the context of their perceived work ability

OBJECTIVES

Physical activity (PA) is important for the prevention and management of numerous diseases and may have a positive effect on ability to work. The study aimed to assess the level of occupational and leisure time PA of soldiers during the COVID-19 pandemic and to explore whether there was a relationship between PA and perceived work ability.

MATERIAL AND METHODS

The study involved 305 men and 68 women who were territorial army soldiers aged 18-55 (M±SD 32.9±9.01). The Seven-Day Physical Activity Recall (SDPAR) and the Work Ability Index (WAI) were used.

RESULTS

The level of self-reported PA for the studied soldiers was relatively high; 80% of them met the recommendations of the WHO and were characterized by having a good (60%) or excellent (20%) WAI status. The level of occupational PA of male soldiers was higher than the level of leisure time PA, and they indicated higher levels of occupational PA and leisure time PA during the workweek than the weekend.

CONCLUSIONS

Current work ability in comparison to the best in life and work ability related to the physical requirements of the work were positively correlated with leisure time PA. Work ability related to physical requirements was also positively correlated with occupational and total PA, and work ability related to mental requirements was positively correlated with total PA. The study supports the relationship between PA and several aspects of work ability. Int J Occup Med Environ Health. 2022;35(3):327-37.

COVID-19 and low back pain: previous infections lengthen recovery time after intradiscal ozone therapy in patients with herniated lumbar disc

Purpose

To assess and compare the clinical effectiveness of percutaneous intradiscal ozone therapy in patients affected by lumbar disc herniation, with and without history of COVID-19 infection.

Materials and Methods

After the rising of COVID-19 pandemics in Italy, 47 consecutive percutaneous intradiscal ozone therapies were performed on patients with low back pain and/or sciatic pain due to lumbar disc herniation. Among these, 19 had suffered from COVID-19 and successively recovered with no residual symptoms, while the remaining 28 had not previously been affected by COVID-19 and were not convalescent. Oswestry Disability Index (ODI) was administered before the treatment and at 1-month and 3-month follow-up in order to assess the clinical outcome.

Results

The two groups were similar in terms of patient age (p-value 0.54), treated levels (p-value 0.26) and pre-procedure ODI (p-value 0.33). Technical success was achieved in all cases. In patients previously affected by COVID-19, mean ODI decrease was 11.58 ± 9.51 (35.72%) at 1-month follow-up and 20.63 ± 9.87 (63.63%) at 3-month follow-up. In patients never affected by COVID-19, mean ODI decrease was 20.93 ± 10.53 (58.73%) at 1-month follow-up and 22.07 ± 11.36 (61.92%) at 3-month follow-up. Eventually, clinical success was registered in 84.21% (16/19) of patients with history of COVID-19 infection and in 85.71% (24/28) of patients with no history of COVID-19 infection. No major complication was registered.

Conclusions

In case of lumbar disc herniation treated with percutaneous intradiscal ozone therapy, patients previously affected by COVID-19 showed a significantly longer recovery time.

Association of Physical Activity and Quality of Life with Work-Related Musculoskeletal Disorders in the UAE Young Adults

Background: Work-related musculoskeletal disorders (WRMSDs) pose threat to the global economy and work productivity. Though growing evidence shows physical activity and quality of life are major determinants for WRMSDs, the association between physical activity and the quality of life among the young adults of the United Arab Emirates (UAE) remains unclear. Methods: In a cross-sectional study, a total of 507 young adults who were between the ages 18–35 years were administered an interviewer-based survey on musculoskeletal disorders, physical activity, and quality of life. The association between the potential determinants and the WRMSDs was analyzed using linear and logistic regression models. Results: High prevalence (75%) of WRMSDs was found among the UAE young adults. Participants with low leisure-time physical activity had few WRMSDs. There was no significant association between physical activity or quality-of-life scores with the incidence of WRMSDs although physical activity time was highly associated with the quality of life, especially the social domain. Conclusion: Though a high prevalence of WRMSDs among UAE men and women was found, neither physical activity nor the quality-of-life scores determined the incidence of WRMSDs.